University of Florida College of Medicine, Gainesville, FL, USA.
Biostatistics-Division of Quantitative Sciences, UF Health Cancer Center, University of Florida, Gainesville, FL, USA.
Am J Otolaryngol. 2021 Jan-Feb;42(1):102793. doi: 10.1016/j.amjoto.2020.102793. Epub 2020 Oct 24.
Human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) treatment outcomes are re-defining management. Traditional margins, the role of extranodal extension (ENE) and adjuvant treatment intensity continue to be debated. This study aimed to determine the impact of margins, ENE and adjuvant therapy on survival following transoral robotic surgery (TORS).
Patients treated with TORS at an academic center were retrospectively identified (2013-2019). Survival outcomes were evaluated using Kaplan-Meier curves.
48 patients were included. 40 (83%) were male. Mean age was 61.2 years. 43 (90%) were stage I. 22 (45.8%) had ENE. 31 (65%) had margins >1 mm. 38 (79%) had indications for radiation therapy; 9 (24%) refused. Chemotherapy was recommended in 36 (75%) patients; 24 (67%) refused. Locoregional control was 98%, metastasis-free survival was 96%, and disease-specific survival was 100% at 5-years. Overall survival was 95%.
Given the high survival rate seen after TORS, it is likely that margins, ENE and adjuvant treatment may not significantly contribute to outcomes.
人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）的治疗结果正在重新定义治疗策略。传统的切缘、淋巴结外侵犯（ENE）的作用和辅助治疗强度仍存在争议。本研究旨在确定经口机器人手术（TORS）后切缘、ENE 和辅助治疗对生存的影响。
回顾性分析在学术中心接受 TORS 治疗的患者（2013-2019 年）。使用 Kaplan-Meier 曲线评估生存结果。
共纳入 48 例患者。40 例（83%）为男性，平均年龄为 61.2 岁。43 例（90%）为 I 期，22 例（45.8%）有 ENE，31 例（65%）切缘＞1mm，38 例（79%）有放疗指征，9 例（24%）拒绝放疗。建议 36 例（75%）患者化疗，24 例（67%）拒绝。5 年时局部区域控制率为 98%，无转移生存率为 96%，疾病特异性生存率为 100%，总生存率为 95%。
鉴于 TORS 后生存率较高，切缘、ENE 和辅助治疗可能对结局没有显著影响。
